Parkinson's disease (PD) is a chronic, progressive neurodegenerative disorder impacting over 10 million individuals worldwide. Characterised by motor and non-motor symptoms, its pathogenesis involves the loss of dopaminergic neurons in the substantia nigra. This article aims to provide an in-depth overview of PD, its current diagnostic criteria, treatment options, and recent advancements in the field.
Diagnosis of PD is primarily clinical, relying on the presence of cardinal motor symptoms - bradykinesia, resting tremor, rigidity, and postural instability. Non-motor symptoms such as sleep disturbances, cognitive impairment, and autonomic dysfunction often precede motor symptoms and contribute significantly to disease burden. Neuroimaging and biomarkers are emerging diagnostic tools, but their role remains supplementary.
Management of PD is symptomatic, aiming to improve quality of life. Pharmacological therapy primarily involves dopamine replacement or modulation, with Levodopa being the mainstay. Deep Brain Stimulation (DBS) offers an effective surgical approach for patients with advanced disease or medication-related complications. However, neither modality halts disease progression.
Recent research has focused on neuroprotective strategies and disease-modifying therapies. The repurposing of existing drugs, such as the diabetes medication exenatide, has shown promising results in slowing disease progression. The role of gut microbiota in PD pathogenesis has also been explored, opening avenues for potential therapeutic interventions. Additionally, advancements in neuroimaging techniques and biomarkers are improving early diagnosis and monitoring of disease progression.
Understanding of PD has significantly evolved over the past decades, yet challenges remain in early diagnosis and disease-modifying treatment. Continued research and collaboration across multidisciplinary teams are crucial to further advance our knowledge and improve patient outcomes. As clinicians, staying abreast of these developments is instrumental in providing optimal care to our patients.
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